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Survival Rates between Early Stage Endometrial Carcinoma With or Without Para-Aortic Lymph Node Resection

Thanagumtorn K

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Thanagumtorn K. Survival Rates between Early Stage Endometrial Carcinoma With or Without Para-Aortic Lymph Node Resection. J Med Assoc Thai 2016;99:975.

Background: In 1988, the International Federation of Gynecology and Obstetrics (FIGO) introduced the concept of surgical staging of endometrial cancer. Pelvic lymph node resection is a part of our routine procedure for all endometrial cancer patients while the use of para-aortic lymph node resection is at the discretion of the physician during surgery.

Objective: To compare the survival rates of endometrial cancer patients receiving pelvic lymph node resection with patients receiving pelvic and para-aortic lymph node resection.

Material and Method: This was a retrospective cohort study of early stage endometrial cancer patients that underwent surgical staging with or without para-aortic lymph node resection. Eighty patients were in the only pelvic lymph node resection group (PLN group), and 284 patients were in the combined pelvic and para-aortic lymph node resection group (PPALN group). The survival data were analyzed using the Kaplan-Meier method, and the log-rank test was employed to compare the survival curves of the two groups.

Results: The median follow-up period was 31.5 months. Median number of pelvic lymph nodes removed was 9 (1-33) for the PLN group and 14 (3-44) for the PPALN group. Median number of para-aortic nodes removed was 2 (0-12), and the rate of lymph node metastasis was 8.24%. In the PPALN group, 3.52% of patients had para-aortic lymph node metastasis. The overall 3- and 5-year survival rates were 90.9% and 87.4%, respectively for the PLN group as compared to 93.2% and 88.7% respectively for the PPALN group (p = 0.484).

Conclusion: The survival rate of early stage endometrial carcinoma patients that underwent surgical staging with or without para-aortic lymph node resection is comparable.

Keywords: Para-aortic nodes, Endometrial cancer, Lymphadenectomy

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